Provider First Line Business Practice Location Address:
1821 FARR ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCRANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18504-1131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-687-0947
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/12/2020